Glucagon-Like Peptide-1 Receptor Agonist Utilization in Type 2 Diabetes in Japan: A Retrospective Database Analysis (JDD
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ORIGINAL RESEARCH
Glucagon-Like Peptide-1 Receptor Agonist Utilization in Type 2 Diabetes in Japan: A Retrospective Database Analysis (JDDM 57) Yasushi Ishigaki . Alena Strizek . Toshihiko Aranishi
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Nobuhiro Arai . Takeshi Imaoka . Zhihong Cai . Hiroshi Maegawa
Received: August 17, 2020 / Accepted: November 24, 2020 Ó The Author(s) 2020
ABSTRACT Introduction: There are limited real-world data on the prescribing of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for patients with type 2 diabetes mellitus (T2DM). Methods: This was a retrospective analysis of the CoDiCÒ database of the Japan Diabetes Clinical Data Management Study Group (JDDM). Demographic and clinical characteristics, concomitant treatment patterns, and GLP1 RA treatment persistence or modification in
Supplementary Information The online version of this article (https://doi.org/10.1007/s13300-020-00977w) contains supplementary material, which is available to authorized users. Y. Ishigaki Division of Diabetes, Metabolism and Endocrinology, Iwate Medical University, Morioka, Japan A. Strizek Eli Lilly and Company, Sydney, Australia T. Aranishi (&) T. Imaoka Z. Cai Eli Lilly Japan K.K., Kobe, Japan e-mail: [email protected] N. Arai Deloitte Tohmatsu Consulting LLC, Tokyo, Japan H. Maegawa Department of Medicine, Shiga University of Medical Science, Shiga, Japan
patients with T2DM initiating GLP-1 RA therapy were evaluated. Results: The analysis included 932 eligible patients with T2DM who had their first GLP-1 RA prescription (index date) between September 2016 and July 2018. Mean age was 63.8 years and 56.0% were male. Most patients had an index GLP-1 RA of dulaglutide (65.7%) or liraglutide (29.1%). Common comorbidities were obesity (58.7%), hypertension (54.7%), dyslipidemia (52.0%), retinopathy (11.3%), and nephropathy (10.2%). Mean hemoglobin A1c (HbA1c) levels decreased from 8.3 to 7.8% over 6 months after GLP-1 RA initiation, and the proportion of patients achieving HbA1c \ 7.0% increased from 14.4% at index date to 22.9% at 6 months. Reductions occurred in mean body weight, body mass index, triglycerides, total cholesterol, lowdensity lipoprotein cholesterol, and adjusted urinary albumin over 6 months. Antidiabetic medication use decreased after GLP-1 RA initiation, whereas non-antidiabetic medication prescribing showed little change. Index GLP-1 RA persistence rates were 80.5%, 66.2%, and 51.6% at 6, 12, and 18 months post-index, respectively, with a median persistence until discontinuation or switch of 600 days. Persistence rates at 6, 12, and 18 months post-index, respectively, were 81.9%, 70.7%, and 65.4% for dulaglutide and 79.7%, 60.0%, and 30.4% for liraglutide. Conclusion: The study shows real-world benefits of GLP-1 RA therapy for T2DM, including improvements in HbA1c, body weight, and
Diabetes Ther
blood lipid profile, and supports the high rates of long-term persistence previously reported with dulaglutide, the GLP-1 RA most commonly prescribed for T2DM in Japanese clinical practice.
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